Transplant Details

As the transplant timeline approaches, I thought it would be interesting for many of you to know more about this process. If you have Googled "bone marrow transplant" - as I did - you will find what is planned for me is different than what is described online.

On Tuesday, June 30th, Ed and I will have several appointments at Northwestern. We will drive up the day before so Ed can get started at 8:30 am with his appointments which will check his overall health ahead of donating. My appointments include meeting my transplant coordinator in person for the first time, blood work, meeting with my transplant doctor, and having a fourth bone marrow biopsy.

On Monday, July 6th, my parents and I will drive up to Chicago to check-in to a hotel room at the Hyatt which is adjacent to and has a partnership with Northwestern Hospital. We've reserved a room there for at least one month so my Mom and any family who visit have a "home base." There are walkways which connect the hotel to the hospital campus for the convenience and safety of "commuting" to my room each day.

On Tuesday, July 7th, I am scheduled to be admitted to Northwestern at 7:30 am. I will have a PICC line with three accessways placed in my arm that day as well as plenty of time to get settled into my room.

On Wednesday, July 8th, the preparation for the transplant will begin. I will receive two types of chemo for four days, then a break for one day, and then a final day of chemo. I have been told I should feel relatively fine for this first week.

Ed will come to Northwestern a week after me to begin his stem cell donation process, which is called apheresis, He will have taken medication for five days leading up to this which will stimulate his stem cell production more than usual. He will be attached to a machine via a catheter in his neck which will remove the stem cells from his blood. This process could take several hours or even be divided into two days. If more stem cells are taken than I need for my transplant, then the excess cells will be frozen and can be kept for decades - which means they are available if I ever need them again. (This is amazing and very reassuring!)

The transplant, for me, is not what you might have in mind - Ed's stem cells will enter my body through my PICC line. This will also be a several hour process, and it isn't an anticlimactic, intense event such as an organ transplant. It will take about 14 days to determine if my "new" bone marrow is really working, which means I may need transfusions of many types in the meantime. I will be very carefully monitored for quite some time for graft vs. host disease - which basically means my body is rejecting and/or reacting to Ed's stem cells.

The transplant will also overstimulate the production of T-cells in my body. T-cells are the "special forces" within our blood that coordinate immune response. While T-cells are typically helpful, in this case, they can be harmful. The T-cells can't distinguish "good" cells from "bad" cells, and so they may invade the bone marrow, thinking something is going wrong, and interfere with the success of the transplant. For this reason, I will be given Methotrexate the day after the transplant in order to suppress the T-cells, which are a type of white blood cell. The Methotrexate will wipe out what little white blood cells I have, cause unpleasant side effects such as GI issues and hair loss, and generally make me glad I'm in the hospital at that point. I am scheduled to receive Methotrexate four times over the ten days following the transplant.

After all of that, it will simply be recovery. I will be hospitalized for about one month total. Following discharge, I would be allowed to come directly home with a lot of restrictions; however, I am very much considering remaining in Chicago, in our hotel room, to be close to Northwestern as the "outpatient" recovery process begins. One of the biggest stressors for me when the second round of chemo destroyed my blood counts was being my own doctor at home - not knowing whether or not I should call my doctor when I felt odd things happening. There are potential risks of my recovery which cannot be handled by local-to-me hospitals, meaning I may have to make an emergency trip to Chicago should something go wrong. I would like to avoid such a trip, if possible! So this means more time away from home, but in the long run, it may be worth it.